Approaches to Patient Health Information Exchange and Their Impact on Emergency Medicine

2006 ◽  
Vol 48 (4) ◽  
pp. 426-432 ◽  
Author(s):  
Jason S. Shapiro ◽  
Joseph Kannry ◽  
Mark Lipton ◽  
Eric Goldberg ◽  
Paul Conocenti ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Patient Health ◽  
Patient Health Information

scholarly journals Health information exchange policies of 11 diverse health systems and the associated impact on volume of exchange

2016 ◽  
Vol 24 (1) ◽  
pp. 113-122 ◽  
Author(s):  
N Lance Downing ◽  
Julia Adler-Milstein ◽  
Jonathan P Palma ◽  
Steven Lane ◽  
Matthew Eisenberg ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
External Information ◽  
Policy Decisions ◽  
Optimal Care ◽  
Specific Patient ◽  
Patient Consent ◽  
Patient Health ◽  
Patient Health Information

Background: Provider organizations increasingly have the ability to exchange patient health information electronically. Organizational health information exchange (HIE) policy decisions can impact the extent to which external information is readily available to providers, but this relationship has not been well studied. Objective: Our objective was to examine the relationship between electronic exchange of patient health information across organizations and organizational HIE policy decisions. We focused on 2 key decisions: whether to automatically search for information from other organizations and whether to require HIE-specific patient consent. Methods: We conducted a retrospective time series analysis of the effect of automatic querying and the patient consent requirement on the monthly volume of clinical summaries exchanged. We could not assess degree of use or usefulness of summaries, organizational decision-making processes, or generalizability to other vendors. Results: Between 2013 and 2015, clinical summary exchange volume increased by 1349% across 11 organizations. Nine of the 11 systems were set up to enable auto-querying, and auto-querying was associated with a significant increase in the monthly rate of exchange (P = .006 for change in trend). Seven of the 11 organizations did not require patient consent specifically for HIE, and these organizations experienced a greater increase in volume of exchange over time compared to organizations that required consent. Conclusions: Automatic querying and limited consent requirements are organizational HIE policy decisions that impact the volume of exchange, and ultimately the information available to providers to support optimal care. Future efforts to ensure effective HIE may need to explicitly address these factors.

Health Information Exchange in Emergency Medicine

2016 ◽  
Vol 67 (2) ◽  
pp. 216-226 ◽  
Author(s):  
Jason S. Shapiro ◽  
Diana Crowley ◽  
Shkelzen Hoxhaj ◽  
James Langabeer ◽  
Brian Panik ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange

scholarly journals Improving Access to Longitudinal Patient Health Information within an Emergency Department

2012 ◽  
Vol 03 (03) ◽  
pp. 290-300 ◽  
Author(s):  
S. Shen ◽  
D.A. Dorr ◽  
G. Hripcsak ◽  
L. Heermann ◽  
S.P. Narus ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
User Authentication ◽  
Tracking System ◽  
Clinical Information ◽  
Before And After ◽  
Patient Health ◽  
The Impact

SummaryWe designed and implemented an electronic patient tracking system with improved user authentication and patient selection. We then measured access to clinical information from previous clinical encounters before and after implementation of the system. Clinicians accessed longitudinal information for 16% of patient encounters before, and 40% of patient encounters after the intervention, indicating such a system can improve clinician access to information. We also attempted to evaluate the impact of providing this access on inpatient admissions from the emergency department, by comparing the odds of inpatient admission from an emergency department before and after the improved access was made available. Patients were 24% less likely to be admitted after the implementation of improved access. However, there were many potential confounders, based on the inherent pre-post design of the evaluation. Our experience has strong implications for current health information exchange initiatives.

Exploring Health Information Exchange Through a System of Systems Framework

2020 ◽  
Vol 5 (2) ◽  
pp. 1-12
Author(s):  
Chaojie Wang
Keyword(s):  
Health Information ◽  
Systems Engineering ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Collaborative Governance ◽  
System Of Systems ◽  
Care Quality ◽  
Patient Centered ◽  
Sos Model ◽  
Patient Health

Clinical decisions require timely availability of holistic patient health information including clinical, demographic, behavioral, and socioeconomic risk factors. Health information exchanges (HIEs) help bridge the technical and organizational divides between disparate Electronic health records (EHR) systems and facilitate the sharing of health information between providers and between patients and providers through collaborative governance, secure protocols, and interoperable standards. HIEs come in many varieties and can be highly complex, both technically and organizationally. This conceptual paper adopts a system of systems (SoS) framework from the systems engineering discipline to analyze and break down the complexity of HIEs. The mnemonic nature of the five characteristics of the Boardman and Sauser SoS Model (A for Autonomy, B for Belonging, C for Connectivity, D for Diversity, and E for Emergence) makes it easier to understand the intricacy of HIEs and helps remove the barriers to effective use of HIEs for care coordination, patient safety, and patient-centered care quality.

scholarly journals Maturity assessment of Kenya’s health information system interoperability readiness

2021 ◽  
Vol 28 (1) ◽  
pp. e100241
Author(s):  
Job Nyangena ◽  
Rohini Rajgopal ◽  
Elizabeth Adhiambo Ombech ◽  
Enock Oloo ◽  
Humphrey Luchetu ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Working Group ◽  
Data Exchange ◽  
Enterprise Architecture ◽  
Health Information Exchange ◽  
Digital Health ◽  
Health Information System ◽  
Maturity Level ◽  
Technical Standards

BackgroundThe use of digital technology in healthcare promises to improve quality of care and reduce costs over time. This promise will be difficult to attain without interoperability: facilitating seamless health information exchange between the deployed digital health information systems (HIS).ObjectiveTo determine the maturity readiness of the interoperability capacity of Kenya’s HIS.MethodsWe used the HIS Interoperability Maturity Toolkit, developed by MEASURE Evaluation and the Health Data Collaborative’s Digital Health and Interoperability Working Group. The assessment was undertaken by eHealth stakeholder representatives primarily from the Ministry of Health’s Digital Health Technical Working Group. The toolkit focused on three major domains: leadership and governance, human resources and technology.ResultsMost domains are at the lowest two levels of maturity: nascent or emerging. At the nascent level, HIS activities happen by chance or represent isolated, ad hoc efforts. An emerging maturity level characterises a system with defined HIS processes and structures. However, such processes are not systematically documented and lack ongoing monitoring mechanisms.ConclusionNone of the domains had a maturity level greater than level 2 (emerging). The subdomains of governance structures for HIS, defined national enterprise architecture for HIS, defined technical standards for data exchange, nationwide communication network infrastructure, and capacity for operations and maintenance of hardware attained higher maturity levels. These findings are similar to those from interoperability maturity assessments done in Ghana and Uganda.

scholarly journals Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings

2014 ◽  
Vol 33 (9) ◽  
pp. 1672-1679 ◽  
Author(s):  
Michael F. Furukawa ◽  
Jennifer King ◽  
Vaishali Patel ◽  
Chun-Ju Hsiao ◽  
Julia Adler-Milstein ◽  
...  
Keyword(s):  
Health Information ◽  
Patient Engagement ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Substantial Progress ◽  
Ehr Adoption
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